Individual provider Active NPI

Philip Michael Robitaille, DDS

  • Dentist
  • Somerset, MA
National Provider Identifier
1124046685
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13708 Issued in MA
Practice address
191 Slades Ferry Ave
Somerset, MA 02726-1201
Phone
(508) 674-0551
Fax
(239) 236-2100
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13708 MA Primary

Addresses

Primary practice location

191 Slades Ferry Ave
Somerset, MA 02726-1201

Mailing address

191 Slades Ferry Ave
Somerset, MA 02726-1201
Phone (508) 674-0551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160608001599 MA Order and Referring Only - DentistPractitioner - Dentist 8820309453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13708MAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1124046685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 SLADES FERRY AVE",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027261201",
            "telephone_number": "508-674-0551",
            "fax_number": "239-236-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 SLADES FERRY AVE",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027261201",
            "telephone_number": "508-674-0551",
            "fax_number": "239-236-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBITAILLE",
        "first_name": "PHILIP",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "13708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, MA

Sources for this page

Verify at the official NPI Registry.